Chronic suppurative osteomyelitis with proliferative periostitis related to a fully impacted third molar germ: a report of two cases

Abstract

In prolonged chronic osteomyelitis, chronic inflammation and low-grade infections can result in new periosteal bone formation. Chronic osteomyelitis with proliferative periostitis (traditionally termed Garré's sclerosing osteomyelitis) mainly affects children and young adults. Here, we present two rare cases of an 11-year-old and a 12-year-old patient with suppurative chronic osteomyelitis with proliferative periostitis without any definitive infection source, such as dental caries or periodontitis. The source of infection was likely to be related to the development of a lower right third molar germ with follicular space widening. Management involved antibiotics and the removal of the third molar germ and surgical debridement. Disease remission and a normal appearance was observed at the six-month follow-up visit.

A Case of Pediatric Garré’s Osteomyelitis Caused by Germ Infection in the Lower Impacted Wisdom Tooth

“…Garré's osteomyelitis caused by germ infection in the mandibular wisdom teeth is an extremely rare condition. [8][9][10][11] In the current case, the second molar on the lower right of the mandible partially erupted and a wisdom tooth was also affected. The reason for this could be that bacteria may have entered through the periodontal pocket of the second molar on the lower right of the mandible, causing an infection of the dental germ of the wisdom tooth.…”

Suppurative Chronic Osteomyelitis: Case Report

“…Based on the literature findings on antibiotic therapy in cases of CSOs, we have clindamycin 150 mg orally, clindamycin 300 mg, it is chosen because of its broad spectrum of antibacterial action, including anaerobic microorganisms and its potential for penetration, consequently reaching high concentration levels in the bone [10,14]. First-generation cephalosporin and clindamycin for two weeks proved to be effective in treatment, as well as amoxicillin clavulanate [12], amoxicillin 500 mg associated with metronidazole 400 mg for seven days this approach achieved good results with no signs of relapse in the first 6 months [13], cephalosporin third generation (ceftriaxone 1 g) twice daily and metronidazole 100 ml three times a day, also proved to be effective, based on culture sensitivity reports [9], all reported the need to combine antibiotic therapy and surgical debridement to treatment is effective in cases of CSO. Among the indicated treatments, the curettage of the lesion associated with antibiotic therapy is the most advised, as they should extend throughout the soft tissues and devitalized bone for successful treatment, as well as systemic use of antimicrobials, usually of ample spectrum of action.…”

“…Treatment of osteomyelitis of the jaws includes removal of the cause such as rupture of the infection, drainage and irrigation, antibiotic therapy being oral and parenteral (oral, clindamycin 150 mg, clindamycin 300 mg, Amoxicillin 500 mg associated with Metronidazole 400 mg, Cephalosporin first generation, Amoxicillin + Clavulanate, parenteral ceftriaxone 1 g twice daily and metronidazole 100 ml three times daily), extraction of teeth, debridement and removal of necrotic bone tissue, it is also possible to use laser therapy with hyperbaric oxygen, especially mandibular irradiation [4,5,9,10,[12][13][14].…”

Chronic suppurative osteomyelitis secondary to endodontic treatment and posterior extraction of mandibular third molars: An uncommon case

“…Dear Editor, Suppurative osteomyelitis is an inflammatory process of acute or chronic nature that affects the bone and bone marrow. [1][2][3] Characteristically, it is marked by progressive destruction of the cortical bone and marrow cavity. Its aetiology is associated with an inflammatory response induced by bacterial invasion arising from odontogenic infections, maxillofacial trauma and surgical procedures.…”

“…Its aetiology is associated with an inflammatory response induced by bacterial invasion arising from odontogenic infections, maxillofacial trauma and surgical procedures. 3,4 In general, different bone sites are affected by this infectious process, including appendicular skeleton (e.g. femur, tibia and humerus) and axial skeleton (e.g.…”